A pebble
Scrupulosity comes from the Latin scrupulus, a small sharp stone, like a pebble in your sandal. It described a nagging worry of conscience you can’t ignore.
A Short History of OCD
ERP for OCD For clinicians
Know exactly which exposure your OCD client needs next.
The Clinician’s Cookbook for OCD Exposure Therapy. 99 ready-to-run ERP recipes across 12 OCD subtypes, sorted by the fear underneath.
Your client does every bit of the homework and still isn’t getting better. Most of the time the exposure is aimed at the wrong fear. This book shows you which of the five levels the fear sits on, then walks you through the exposure that hits it.
Not a clinician? Coaches and families use it too.
99Exposure recipesPick one and run it in your next session
12OCD subtypesGo straight to your client’s subtype
5LevelsKnow where to aim each exposure
2EditionsOne for your desk, one for the road
Look inside
Watch the pages turn
Real pages from the book, one spread at a time. This book is 852 pages, beautifully laid out in full color.
- Recipe card and the Proximity Paradox
- The Five Levels
- Breaking the OCD Cycle
- Five Families of Rumination
- How to Run an Exposure
- Six Compulsion Types
Sound familiar?
If you treat OCD, you’ve been here
New to the OCD specialty
Your first OCD client is on the schedule, and you’re not sure what to do once the door closes. The book takes you session by session, from the first exposure to the last.
Your ERP has stalled
Your client works hard and still isn’t moving. The five levels show you where the fear really sits, so you can aim there instead.
Training a team
You want everyone on your team running ERP the same way. Every recipe follows the same layout and the same five SENSE steps, so the whole team works from one playbook.
Supervising other clinicians
Your supervisee says the exposure didn’t work, and neither of you can see why. Each recipe names its target, the emotion and how long it runs, so the two of you can talk through what missed in the same terms.
Who else reads it
Clinicians
The book is written for you first. Find the recipe for your client’s fear and run it next session.
Coaches
You get the structure, the five levels and the exact language of the method to use alongside a licensed therapist.
Families
The recipes show you what real ERP looks like, so you can tell whether your loved one is getting it. Every subtype chapter ends with pages written for you. They tell you what to stop doing and give you one line to say. What to ask a therapist
For parents and families: what real OCD treatment looks like
Many therapists list OCD. Fewer are trained to treat it. A few direct questions will tell you which kind you’re talking to.
In real ERP, your child faces the fear on purpose, a step at a time, with the therapist right there, and practices not doing the compulsion. Talking about feelings isn’t ERP. Neither are relaxation and breathing exercises on their own.
What should parents ask a therapist about OCD treatment?
Ask what specific training they’ve had in ERP for OCD, and whether your child will actually do exposures in session with the therapist in the room. Those two answers tell you most of what you need to know.
Six questions to bring to any therapist:
- “What specific training have you had in ERP for OCD?”
- “Will we actually do exposures in session, with you there?”
- “How do you build an exposure plan, and how do you handle reassurance-seeking?”
- “Have you treated obsessions like my child’s, including taboo or scary ones?”
- “What will homework between sessions look like?”
- “What kind of CBT do you provide?” (researchers who surveyed US therapists suggest families ask exactly this)
If the answers are vague, keep looking. Fit matters, and no therapist can promise a result. But you can ask for the treatment the guidelines name first.
Nobody taught most of us this
You probably didn’t learn to treat OCD in graduate school. Almost none of us did. The treatment that works is exposure and response prevention, ERP for short, and clients who stick with it get better. Too few therapists were ever shown how to run it.
Your clients are the ones who pay for that gap. So I put ERP on paper, the way we actually run it, so you can be the therapist who runs the exposure instead of talking around it.
- Fewer than 1 in 10 US therapists who treat anxious kids said more exposure therapy training would do them no good. The other 92% said they’d benefit from more of it.Reid et al., 2018, United States
- Over 1 in 3. Shown an OCD case with harm obsessions, 125 of 353 therapists would not recommend ERP or would not take the case at all.Jelinek et al., 2021, Germany
“A cookbook. Recipes you can read, run, and make your own, so the next person who walks in with OCD does not have to wait fifteen years for someone who knows what to do.”
The training gap is everywhere. Is it in your office?
How many therapists actually use exposure for OCD?
Fewer than you’d hope. ERP is the first-line treatment for OCD, and researchers in four countries keep finding clinicians reaching for something else.
17 years
On average, symptoms started at about 14½ and the right treatment at about 31½. Every year in between was someone’s adolescence or young adulthood.Hollander, 1997
30% vs 49%
US private-practice therapists treating kids with OCD guided exposure about 30% of the time. They used breathing retraining 49% of the time. A relaxation skill got used more often than the treatment that works.Reid et al., 2018
1 in 8
Of 202 adults in OCD treatment, 1 in 8 got the recommended dose of CBT within two years. The other seven didn’t get the full course.Mancebo et al., 2011
Outside the US, same pattern
- AustraliaNot one. Of 25 typical Australian clinicians who work with kids, not one rated themselves very experienced at treating youth OCD. 92% had no specialized OCD training beyond grad school.Racz et al., 2025
- Germany71%. In interviews with former OCD patients, 71% of their behavior therapies included no exposure at all.Böhm et al., 2008
- United KingdomMore than 1 in 3. Of 107 UK clinicians treating kids with OCD, 36% would not regularly use ERP when the obsessions were taboo.Keleher, Jassi and Krebs, 2020
Be the clinician who knows which exposure to run next.
Choose your editionThe Scoggan Method
ERP you can run step by step
So what do you run instead of breathing exercises? The Scoggan Method is built on exposure and response prevention, and it sorts every fear into one of five levels by what the fear is about. Know the level and you know where to aim.
Level 1
Basic encounter
The client is afraid of, or disgusted by, the thing itself. They touch it or look at it and stay with it.
Level 2
Spread
The client is afraid of spreading it or causing something bad to happen. They spread it on purpose.
Level 3
Guilt
The client feels guilty about a mistake they made or think they made. They tell that story out loud and make it worse.
Level 4
Shame
The client feels ashamed of who they are. They say “I am a bad person” out loud and make it bigger.
Level 5
Existential
The client fears that reality isn’t real or that they don’t belong in it. You target the feeling of being forsaken and out of place in their own life.
Pick the right level and the exposure is easy to plan. Pick the wrong one and it can look perfect on paper and still miss the real fear. To see it in a working clinic, read about how ERP is delivered at The Scoggan Institute.
The Proximity Paradox
A woman has two toilets in her house and can’t use either one. She avoids one because it feels contaminated. She spent six hours cleaning the other, and now it feels too clean to use. Her OCD pushes her away from some things and makes her guard others. The book shows you how to find and treat both.
The emotional bridge
Normally, a thought ends when a feeling tells you it’s done. In OCD that feeling never shows up, so the question keeps looping and no amount of checking settles it. When a client’s SUDS come down and stay down, the feeling is starting to come back. That’s when they start getting their life back.
The whole exposure in one word
Every exposure in the book runs on SENSE. OCD attacks the senses with doubt, and the method walks the client back into them. The five steps never change, so once you know them you can run any recipe.
- SStart and score
- EEnter
- NNotice
- SStop and switch
- EEndure and track
When you aren’t there, your client has RE-TRAIN, the version they take home and run on their own when a compulsion hits.
What to say in session
The book writes out what to say, including the line that names the emotion your client should move toward. When the anxiety spikes, you won’t be making it up on the spot.
How to read a recipe card
One fear per recipe. Find your client’s fear and run it.
Here’s what one looks like. Every recipe uses the same layout, so once you can read one card you can read all 99. The front tells you how to run the exposure. The back explains the method behind it.
Click Front or Back to turn the card over
1
2
3
4
5
6
7
8
9
Contamination, Recipe 2, Spreading Germs After a Cough. The card is printed on pages 263 and 264 of the Travel Size, and the full recipe runs on pages 265 to 271. Click any number on the card to light up that part and see what it does.
- 1The target: Level 2, spread fear
The client is not afraid of the cough. They are afraid of what travels out of it, through their hands, into the world. So the exposure can’t be a touch. It has to be the transfer itself.
- 2The exercise, run as Bounty Hunter
The client coughs into bare hands and spreads it on purpose, moving from their own things to shared surfaces, then to food they’ll eat and a person who has agreed. A spread fear is about movement, so the exposure moves. They scan for the highest-SUDS target, spread, feel the partial drop and hunt the next one. The full recipe adds their voice: while they spread, they proclaim, “I’ll spread these GERMS ALL OVER THE PLANET.” Said with conviction, it flips what the book calls the confidence switch.
- 3The second half: contaminate what they protect
After the exercise on their own things and shared surfaces, the client does a second half at home, with the things they protect. Cough, then touch the food they eat, the counter, the towel, the bed.
- 4The level check: is this a Level 2?
Stay at the level. This card is Level 2. If the client’s distress turns into guilt over a person they believe they’ve harmed, that’s Level 3, and it has its own recipe. Running this card on a guilt fear looks like a failed exposure when it’s really a mistargeted one.
- 5Go toward the emotion, and what you need
The card names the emotion to go toward. Fear is a threat they can name. Anxiety is an alarm with no name on it. To run it you need a real cough into bare hands, their own phone, clothes and chair, a route of shared surfaces to spread onto, and food they will actually eat.
- 6The Proximity Paradox: what they flee, what they guard
This client flees some things: covering the cough, staying out of shops, lifts and crowds, and not touching food or eating with those hands. They also guard others: the kitchen counter, the food, the fridge door, their own bed, their towel, their side of the sofa. The exposure walks toward both. Cough into the bare hands, go where the people are and touch what they touch, then bring it home to the food, the counter, the towel and the bed.
- 7What to look out for
Consenting people only, agreed in advance and knowing exactly what it involves. Never a stranger, and never a child, an elderly person, or anyone immunocompromised. If the client is genuinely ill, this isn’t the day. The food is their own germs, and the spread never goes onto anyone else’s food.
- 8The clinician reminder: the acronyms in play
Run it as S.E.N.S.E.: Start and score, Enter, Notice, Stop and switch, Endure and track. The client holds O.W.N. I.T.: Own it, Welcome it, No rituals, Invert it, Toward it. At the peak, S.T.A.N.D.: Say its name, Take its side, Abstain, Now the opposite, Dive in.
- 9The Scoggan Response Scale
The number sets the body, from 0 to 10. Low is a slow mind and a fast body, so add friction and push deeper. High is a fast mind and a slow body, so soften, stay in it, and do not come out.
A second sample
Flip through the family pages
Every subtype chapter ends with pages you can hand straight to the family. Here are the real pages from the Contamination OCD chapter, 250 to 253 of the Travel Size, as printed in the book. Use the arrows or tap the page to turn it.
Page 250 (1 of 4)
The Desk Reference has the same family section in a larger 8.5 × 11 size. Every subtype chapter has its own set of family pages.
Sneak peek
Before the recipes, the background you’ll use
The book opens with where OCD came from and what the research says now. Then it gets to work, one recipe at a time. A few things you’ll pick up along the way:
“A clinician who knows the history of what they treat is no longer just a clinician. They become the expert.”
The history
OCD has been around for at least two thousand years, long before anyone knew how to treat it. You’ll have stories to share with clients, who often feel less alone when they learn how long people have lived with it.
Besieged
Obsession comes from obsidere, to sit outside a fortress and refuse to leave. Compulsion comes from compellere, to force. These old words described how OCD works long before medicine did.
A Short History of OCD1838
A Paris psychiatrist gave OCD its first medical name, folie du doute, the madness of doubt. By 1875, another French doctor had written a whole book about it.
A Short History of OCD1966
In a London hospital, Victor Meyer stopped two patients from doing their rituals and waited. Their anxiety went up, then came down and stayed down. The first treatment that worked for OCD is only about 60 years old.
A Short History of OCDThe research
Clients and parents will ask what OCD is and where it comes from. These are the numbers you’ll want ready.
Top 10
The World Health Organization ranked OCD among the ten most disabling health conditions in the world. That list counts every kind of health condition, physical ones included.
OCD by the Numbers1 in 40
About 1 in 40 adults has OCD, and that rate hasn’t changed in decades. OCD isn’t on the rise. More people are recognizing it.
A Short History of OCD40 to 50%
About 40 to 50% of the risk for OCD is genetic, spread across many genes. What parents pass down is a higher chance of getting it.
OCD by the NumbersOvernight
In a small number of children, OCD starts almost overnight after a strep infection. This is called PANDAS. It’s rare, but if a child’s OCD starts suddenly, it’s worth telling their doctor.
OCD by the NumbersThe how-to
Then the book shows you how to put all of it to work in your next session.
5 levels
Name the emotion under the fear and you’ll know which level you’re treating and where to aim.
99 recipes
Each recipe is a card you can run in session, so you aren’t building exposures from scratch.
12 subtypes
Each subtype has its own chapter, from contamination to hoarding, and every chapter ends with pages you can hand to the family.
Word for word
The book writes out what to say in session, line by line. Use the lines as written until they’re yours.
The book also tells the stories of a reformer, a preacher, and a dictionary maker who showed signs of OCD centuries before it had a name. It covers Freud’s famous Rat Man case and why experts disagreed about moving OCD out of the anxiety disorders. You’ll also meet public figures who have said they live with OCD.
Get all 99 recipes and the history behind them.
Choose your editionWhat is inside
Four parts, from foundations to the recipes
Part I
Foundations
- Levels of care
- OCD by the numbers
- A short history of OCD
- The OCD brain and the compulsions that drive it
- Cognitive fusion and defusion
- The OCD language
Part II
The Method
- The Scoggan Method
- The neuroscience behind the thought loop
- The mechanics of OCD
- The emotional palette
- The five levels
- The compulsions
- Command OCD
- Rumination
- Top-down and bottom-up processing
- How an exposure actually works
- The Proximity Paradox
Part III
Running It
- Running the exposure
- The five-step posture
- Roles and scripts in the room
- Preparation
- Reading and running a recipe
- Narrative work and the WRITE method
- The method boxes
Part IV
The Recipes
- 99 recipes in 12 subtype chapters
- Family guidance in every chapter
- Glossary
- References
Contamination OCD 12 recipes
Harm OCD 8 recipes
Relationship OCD 8 recipes
Scrupulosity OCD 8 recipes
Sexual Orientation OCD 8 recipes
FAM OCD (False Attraction to Minors OCD) 8 recipes
Health OCD 8 recipes
Existential OCD 8 recipes
Limerence OCD 8 recipes
Emotional Contamination OCD 8 recipes
Digital OCD 8 recipes
Hoarding OCD 7 recipes
Introducing FAM OCD, previously known as POCD
False Attraction to Minors OCD
FAM OCD, short for False Attraction to Minors OCD, is the name we use for the subtype that was previously called POCD. The new name puts the focus where it belongs. People with this subtype are not experiencing real attraction. They are caught in a cycle of unwanted, intrusive thoughts, images, or doubts that feel like attraction and clash with their values. That clash is why the distress is so intense.
Like other forms of OCD, it runs on doubt and a need for certainty. People often check their reactions, avoid children or reminders, or seek reassurance. Those efforts bring short-term relief and keep the cycle going. In exposure and response prevention (ERP), people practice living with the uncertainty instead of doing those compulsions. The FAM OCD chapter in the book has 8 recipes, with family pages at the end.
How often is OCD missed or undertreated?
More often than most clinicians would guess. When US psychologists read a written case of OCD obsessions about being gay, 77% called it something else. In a UK study of patients labeled treatment-resistant, most who believed they’d had CBT never got even a minimal version of it.
For the family, in every chapter
The family pages are written so a tired parent or partner can use them right away. They spell out what to stop doing, so nobody undoes your work between sessions, and they give the family one line to say. You can flip through a real set above.
How to use it
“A good chef learns the recipes and the methods. An amazing chef learns the methods and then makes them their own.”
Start by running the recipes exactly as written. They’ll teach you how the method works and why. Once you know it, make it fit the client in front of you. Try each idea before you decide it’s wrong, and don’t believe any claim just because it sounds confident.
From clinicians
What readers say
Ask yourself: A client walks in tomorrow with an obsession that scares you. Do you run the exposure, or do you talk around it? Are you the therapist they leave?
“New clients tell me they’ve already been through seven, eight, even nine different treatments before they reach me. Some describe a therapist who said they were doing ERP and never once ran an exposure.”
Buy the book
Pick your edition
If one recipe gets one stuck client moving, the book has paid for itself.
Both editions have the same content. Many readers keep the Desk Reference at work and the Travel Size with them.
Pre-orders are opening soon. Email to reserve your copy. Every pre-order ships December 1, 2026.
Desk Reference
The perfect desk reference
Big 8.5 x 11 pages show every recipe card at full size, so it can stay open on your desk mid-session or while you plan.
- Size
- 8.5 x 11 in, paperback
- Pages
- 678
- ISBN
- 979-8-9974988-2-5
$247USD
8.5 × 11 · 678 pages
Pre-order price. Ships December 1, 2026.
Plus shipping, confirmed by email
Reserve the Desk Reference
Travel Size
Made for travel and leisure study
It’s the whole book at 6 x 9, sized for the plane, the couch, supervision, or reading ahead on the weekend.
- Size
- 6 x 9 in, paperback
- Pages
- 852
- ISBN
- 979-8-9974988-0-1
$197USD
6 × 9 · 852 pages
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Reserve the Travel Size
Both editions
One for the desk, one for the road
The Desk Reference and the Travel Size together. You save $97.
$347USD
Desk Reference 678 pages + Travel Size 852 pages
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Reserve both editions and save $97Online checkout is not open yet. The Reserve buttons open an email to us, and we will write back when pre-orders open. Reserving costs nothing and takes no payment. Pre-orders ship December 1, 2026. Shipping is added to your total and confirmed before you pay, and every order ships with tracking. We ship to US addresses only for now. For group practice and training program orders, email contact@ocdcookbook.com. See the terms, shipping, and returns.
About the author
Ricky Scoggan, LMFT
Ricky Ryan Scoggan, LMFT, is the creator of the Scoggan Method and the author of this book. He is licensed in Utah and Arizona and has worked in mental health for 22 years.
He is the founder and clinical director of The Scoggan Institute. He built the method in this book while working with clients. He tells his clients, “Willpower runs out. Mindset doesn’t.”
He also writes about OCD and mental health as a Senior Level Executive Contributor at Brainz Magazine.
Senior Level Executive Contributor, Brainz Magazine
Founder of The Scoggan Institute, named Top Outpatient OCD Treatment Practice 2026 by Medical Care Review Magazine
Recognition for The Scoggan Institute
According to Medical Care Review Magazine, the award reflects evaluation by a panel of medical experts, industry peers, thought leaders, and its editorial board.
Top Outpatient OCD Treatment Practice 2026, awarded to The Scoggan Institute by Medical Care Review Magazine.
Questions
Questions before you buy
Is it worth the price?
The Travel Size (852 pages) is $197 and the Desk Reference (678 pages) is $247 as pre-order prices, and both ship December 1, 2026. Either one gives you the whole book: 99 recipes across 12 subtypes, the five levels, the history and research behind OCD, and pages for the family in every subtype chapter.
When will my book ship?
Pre-orders are opening soon, and you can reserve a copy now by email to contact@ocdcookbook.com. Every pre-order ships December 1, 2026. After that, orders ship within 3 business days of purchase. Shipping is added to your total and confirmed before you pay, and every order ships with tracking. We ship to US addresses only for now.
What is the pre-order refund policy?
If you pre-order, you can ask for a full refund any time before your order ships on December 1, 2026. After it ships, we will refund or replace any copy that arrives damaged or misprinted. Reserving by email costs nothing and takes no payment. Email contact@ocdcookbook.com.
I already have ERP training. Will this add anything?
Yes. It builds on your training. The five levels give you a way to decide where to aim each exposure, and the 99 recipes and scripts give you something to run in your next session.
Will it cover my client’s subtype?
The book has 99 recipes across 12 OCD subtypes: contamination, harm, relationship, scrupulosity, sexual orientation, false attraction to minors (FAM OCD, previously POCD), health, existential, limerence, emotional contamination, digital, and hoarding OCD. Each subtype has its own chapter, and every chapter ends with guidance for the family.
Who is this book written for?
It’s written for clinicians, so parts of it are technical. Coaches use it to learn the structure and language of the method, and families use it to understand ERP and their role at home. Many of the skills work outside of OCD too.
I’m a parent. Is it too clinical for me?
Parts of it are technical, because it’s written for clinicians. The history and research sections read easily, and the family pages at the end of each subtype chapter are written for you.
I’m a coach. Can I use it?
Yes. Use it for the structure and the language of the method, alongside a licensed therapist who handles treatment.
Do I need ERP training to use it?
The book is meant to be part of your training. It walks you through ERP step by step, from the basics through running each recipe. Use it alongside your other training and supervision.
What is The Scoggan Method?
The Scoggan Method is a system for delivering ERP. It sorts every fear into one of five levels and tells you where to aim each exposure. The book teaches the method and its language recipe by recipe, so you can use it in your next session.
What is the difference between the Desk Reference and the Travel Size?
The content is the same. The Desk Reference is 8.5 x 11 inches and 678 pages, with large pages that make the recipe cards easy to read on your desk. The Travel Size is 6 x 9 inches and 852 pages, made for travel and leisure study.
How is this different from other ERP books?
Most OCD books explain the disorder and leave you to figure out what to do in session. This one works like a cookbook. It has 99 recipes you can run right away, one fear per recipe, and five levels that tell you where to aim each exposure. Every chapter also includes guidance for the family.
Can someone use this book to treat their own OCD?
We advise anyone living with OCD to work with a trained therapist. This book is designed as a training tool for therapists and coaches.
Sources
- 17 years: Hollander E. (1997). J Clin Psychiatry 58(suppl 12):3–6. 1996 survey of 701 US OCD Foundation members. https://www.psychiatrist.com/pdf/introduction-obsessive-compulsive-disorder-the-hidden-epidemic-pdf/
- 30% vs 49%; fewer than 1 in 10; 92%: Reid A.M. et al. (2018). J Anxiety Disord 58:8–17. 257 US private-practice therapists treating anxious youth; 179 treated youth with OCD. Asked how much they would benefit from training in exposure therapy, 8% chose “No benefit” on a four-point scale. https://doi.org/10.1016/j.janxdis.2018.06.002
- 1 in 8: Mancebo M.C. et al. (2011). Behav Ther 42(3):399–412. 202 adults, Brown Longitudinal OCD Study; recommended dose = 13+ weekly sessions (as summarized in Senter et al., 2021, Psychiatr Serv 72(7):784–793). https://doi.org/10.1016/j.beth.2010.10.002
- 98% vs 27%: Hipol L.J. & Deacon B.J. (2013). Behav Modif 37(2):170–188. 51 licensed US psychotherapists; 33 treated OCD. https://doi.org/10.1177/0145445512458794
- 77%: Glazier K. et al. (2013). Ann Clin Psychiatry 25(3):201–209. 360 US psychologists (APA members), vignette survey. https://pubmed.ncbi.nlm.nih.gov/23926575/
- More than 1 in 3 (UK): Keleher J., Jassi A., Krebs G. (2020). J Obsessive Compuls Relat Disord 24:100498. 107 UK clinicians treating pediatric OCD. https://doi.org/10.1016/j.jocrd.2019.100498
- Most (UK): Stobie B. et al. (2007). Behav Cogn Psychother 35(3):273–282. 57 treatment-refractory OCD patients. https://doi.org/10.1017/S135246580700358X
- 71%: Böhm K. et al. (2008). Verhaltenstherapie 18(1):18–24. Interviews with former OCD patients, Germany. https://doi.org/10.1159/000115956
- Over 1 in 3 (Germany): Jelinek L. et al. (2021). Behav Ther. 353 therapists in Germany, harm-obsession case vignette. https://doi.org/10.1016/j.beth.2021.05.004
- 37%: Pittig A., Kotter R., Hoyer J. (2019). Behav Ther 50(2):353–366. 684 licensed German outpatient behavior therapists; anxiety disorders generally. https://doi.org/10.1016/j.beth.2018.07.003
- Not one; 17% (Australia): Racz J.I. et al. (2025). Children 12(2):156. 25 typical Australian clinicians working with youth; 17% figure from pilot data reported in the paper (11 clinicians who had treated youth OCD in the prior 12 months). https://doi.org/10.3390/children12020156
- Seven, eight, even nine treatments: Ricky Scoggan, LMFT, clinical observation. Not a research finding.